Global collaboration to prevent pre-eclampsia with aspirin

PEARLS is short for ‘Pre-eclampsia prevention: evaluating aspirin low-dose regimens after risk-screening studies'. It's the world’s largest study on aspirin use to prevent pre-eclampsia.

Preterm pre-eclampsia is a serious pregnancy complication that puts mothers and babies at risk. Working with international partners, and collaborators in Ghana, Kenya and South Africa, we’re conducting a large-scale trial to prevent it.

We’re comparing 2 doses of aspirin (150 mg and 75 mg) to understand which is more effective. The findings could support clinical guidelines on the best dose to prevent pre-eclampsia and save the lives of mothers and babies.

What we're doing

Our study has 3 parts: screening, comparison and evaluation.

Before we begin the study, we need to identify who wants to participate and who would benefit the most. To do this we're surveying more than 16,000 women in Ghana, Kenya and South Africa. This will help us improve our risk-screening tool as we work on predicting who is most at risk of preterm pre-eclampsia. We'll also conduct interviews with these women to understand any barriers that might stop them from joining our study.

Our results will help us identify women who are pregnant and at risk of pre-eclampsia. Those women will have an opportunity to give their informed consent to join this trial. Once enrolled, they'll take either 75 mg or 150 mg of aspirin. While ensuring that women access the necessary medical care, we'll observe the effect of these 2 doses. We'll measure which dose tends to work better against pre-eclampsia and postpartum bleeding.

Alongside the trial, we'll measure and analyse the cost-effectiveness of our study.

Pre-eclampsia explained

Pre-eclampsia is a condition that occurs during pregnancy. It can reduce blood flow to the placenta and cause premature birth. It can cause serious illness, organ damage, seizures and death of the parent or child.

Pre-eclampsia is the leading cause of maternal and newborn deaths worldwide. It leads to an estimated 14% of maternal deaths each year. It’s also connected to around 7% of early newborn deaths.

There’s no cure for pre-eclampsia, so when parents and children don’t have access to health care the condition poses a serious risk. It’s why prevention through aspirin is so important.